American life expectancy continues to decline. What’s going on?

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In this Oct. 22, 2018 file photo, a fentanyl user holds a needle near Kensington and Cambria in Philadelphia. Suicides and drug overdoses helped lead a surge in U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live. U.S. health officials released the latest numbers Thursday, Nov. 29. Death rates for heroin, methadone and prescription opioid painkillers were flat. But deaths from the powerful painkiller fentanyl and its close opioid cousins continued to soar in 2017. (David Maialetti/The Philadelphia Inquirer via AP, File)

With the most advanced medical care that (plenty of) money can buy and an aware 21st-century citizenry full of nonsmokers and rabid exercisers, there’s nowhere for American life expectancy to go but up, right?

Wishing that were so, researchers announced last month that once again we are living shorter than longer lives in the first such trend in a century.

The main culprits? Suicide and drug overdoses. So very clearly, our nation has a long way to go down the roads of mental health and substance-abuse deterrence.

Life expectancy fell for the first time in decades in 2015, USA Today reported. It leveled out in 2016 and then fell again last year. The country is seeing its longest overall downward trend since World War I, a hundred years ago.

The newspaper talked to William Dietz, a disease prevention expert at George Washington University, who said he sees a sense of hopelessness in our land.

Money woes, an increasing income gap and divisive politics cast a pall over many Americans, he said. “I really do believe that people are increasingly hopeless, and that leads to drug use, it leads potentially to suicide,” he said.

Since 2008, suicide has ranked as the 10th-largest reason for American deaths. In 2016, it became the second-leading cause of death for those from 10-34 and the fourth-leading cause for ages 35-54.

Last year, 47,000 people committed suicide, a rate of 14 per 100,000 people. That is up from 10.5 in 1999 and from 13.5 last year.

The leading causes of death are still heart disease and cancer, followed by unintentional injuries. We can and do make progress there thanks to medical research funding and making cars and trucks safer.

But clearly we are losing the battle on our mental as opposed to physical health. Despair is not what becomes a legendary nation best. Draconian drug laws are not putting a stop to the opioid epidemic that affects Americans mostly in the Midwest, Appalachia and the Northeast. No matter what your stance is on gun control, the cold fact is that the majority of suicides are from self-inflicted gunshots.

If this isn’t a national health emergency, this sudden change from decades of life-prolonging progress to this rapid U-turn, then we aren’t sure what one is.

Because at current rates, predictions for the future look even worse. For all our disparagement of Europe, by 2040, Spaniards will overtake the Japanese at No. 1 to live for 85.8 years on average. The United States will fall to 64th, with an average life expectancy of 79.8.

Unless, of course, we do something about it. It’s not just heroin and shots to the head. Obesity in adults is at its highest rate ever in the country, according to the National Center for Health Statistics. That Mediterranean diet in Spain is one of the main reasons its people live so long. Whereas nearly 40 percent of adults and over 18 percent of children in the U.S. are obese on our country’s high-carb, junk-food diets. Not everyone is down at LA Fitness every morning, apparently.

Given the crisis, there should be a national policy of education and action to counter it. But everyone’s future health starts with themselves and their family and circle of friends. Don’t fail to seek their advice. Talk to your physician about diet, exercise and mental health, too. And take good care of yourself.

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